When Pamela Vella was preparing to give birth at Providence Saint John’s Health Center in Santa Monica, she envisioned her partner, mother and sister standing by her side.
But things didn’t go as planned after her mother, who lives in Europe, got into a car accident.
As a first-time mom, Vella worried about whether she was ready to navigate her postpartum recovery away from her mother while taking care of a newborn.
“My biggest fear was that you can do a lot of reading about everything, but when it comes to breastfeeding, it’s all about practice,” said Vella on a recent morning as she sat in a chair in her room at Providence Saint John’s, holding her son Benjamin, just two days old.
Luckily, Vella wasn’t left without support.
As soon as Benjamin was born, the hospital staff connected her with a Los Angeles-based maternal healthcare company called Mahmee, which offers the services of doulas — who provide non-medical emotional support to expecting and new mothers — as well as nurses, care coordinators, mental health coaches, nutritionists and lactation consultants.
First, Vella met with a lactation consultant who helped her pump milk and breastfeed her son — a challenge for many new mothers.
“We’re good now,” she said, and her baby boy has been gaining a healthy amount of weight.
Mahmee’s co-founder and CEO Melissa Hanna said her company based in Los Angeles has been looking for solutions for new mothers and families who might struggle with postpartum recovery or cannot afford a lactation specialist or doula, whose services can cost thousands of dollars.
Hanna, who is also a new mother, said, “I have this personal experience wanting to have providers around me who look like me and understand that I may be experiencing the healthcare industry differently than a White mother or a non-Black mother.”
Saint John’s began offering the Mahmee 30-day complimentary service at the beginning of this year.
Patients will have a complimentary membership for a month post-delivery, offering virtual and in-person consultations with a wide network of specialists. The partnership is part of Providence Southern California’s investment in breastfeeding support and maternal health care.
Nearly 80% of Mahmee’s patients who use their app nationwide, Hanna said, identify as non-White. The company’s focus, she said, is “to meet the needs of very diverse populations.”
Historically, Black mothers and infants have been disproportionately impacted by pregnancy-related and birth-related complications. Black women in the U.S. have a more than three times higher risk of dying during pregnancy and childbirth than White mothers, according to the Centers for Disease Control and Prevention.
Nationwide, nearly 700 women die each year because of pregnancy or delivery complications, giving the U.S. one the highest maternal mortality rates in the developed world. Half of these deaths are preventable, according to the National Institutes of Health.
“Racial and ethnic inequities in obstetrics and gynecology cannot be reversed without addressing all aspects of racism and racial bias, including sociopolitical forces that perpetuate racism,” wrote the American College of Obstetricians and Gynecologists in a statement in 2002.
The mission for her company, Hanna said, is to reverse those statistics.
“That is not achievable unless we support all mothers in having a positive, joyful, safe and healthy birth experience which means focusing on highly marginalized populations like Black and African-American, Indigenous and Native American mothers who have had the worst maternal mortality rates,” she added.
Some of the most popular help that expecting moms and new mothers want, she said, is support from doulas and lactation specialists.
But meeting that demand is challenging because across the country there are not enough doulas.
Witnessing a maternal health crisis as a doula
Stanis Askew has witnessed firsthand how women rely on her support as a doula to get through pregnancy and delivery.
Unlike midwives, doulas don’t deliver babies. Instead, they guide their patients on how to alleviate pain, manage stress, maintain a healthy diet and deal with complications following the delivery.
Askew’s client, April Valentine, went into labor last year at Centinela Hospital in Inglewood. She never returned home.
Before Valentine’s delivery, Askew spent hours on the phone with her client, providing emotional and educational support and preparing her for the delivery.
“I told April, ‘I will educate you so when I’m not there you can advocate for yourself,’” she said.
Askew said that Valentine, 31 years old and Black, hired her as a doula because Valentine was aware of the disturbing statistics showing high mortality rates among Black women in the United States.
“She had the desire to be a mom,” Askew said, remembering the walls in Valentine’s bedroom in Inglewood, covered with affirmations about healthy pregnancy.
But the delivery didn’t go as planned. Her doula was not allowed to be with Valentine during her delivery even though, Askew said, she had a doctor’s permission to accompany her client in the hospital room during birth.
Valentine went to the hospital in early January of 2023. The next day she died while delivering her daughter, Aniya. The Los Angeles County Medical Examiner determined that she died from a blood clot.
If she was with Valentine in her room, doula Askew believes she could have helped her. She has stayed in touch with Valentine’s partner and Aniya who turned 1 year old in January.
“I could’ve helped with the pain management to either prevent the epidural or acknowledge the pain with the epidural was unusual and sought medical attention,” she said.
Valentine’s death prompted an investigation by the California Department of Public Health that in August fined the hospital $75,000 for “deficient practices” followed by the death of a patient during labor.
On Oct. 25, 2023, the hospital closed its maternity ward, citing weakening demand for labor and delivery services. Representatives with Centinela Hospital Medical Center didn’t return requests for comment.
Supporting mothers and families
Askew said it is important to have access to programs like Mahmee where families can find doula care and other services, especially in the first weeks after delivery when families have left the hospital.
“The more we speak about (maternal health), the more eyes and ears are put on it, the bigger it will grow,” she said.
Ivetta Avanesov, a first-time mother who recently gave birth at Saint John’s, said without the support of Mahmee’s lactation consultants, she wouldn’t be able to breastfeed her newborn son, who lost almost a pound in less than a week after he was born.
Avanesov was ready to switch to formula for her baby when a nurse connected her with a lactation specialist who helped her continue breastfeeding. The results didn’t keep her waiting too long.
“My milk supply has increased and my baby is gaining weight and it’s all because of this program,” she said.
“It made the difference because I do want to be a breastfeeding mom.”
Multiple studies have shown that breastfeeding is the most beneficial option for infants. The American Academy of Pediatrics recommends that mothers breastfeed their babies for about six months and then add complementary foods until a child is about two years old.
Breastfeeding helps build a strong immune system and shield babies from diseases including asthma, obesity, type 1 diabetes, and sudden infant death syndrome — or SIDS. When it comes to mothers’ health, breastfeeding lessens the risk of breast and ovarian cancer, type 2 diabetes and high blood pressure, according to the Centers for Disease Control and Prevention.
Since returning to her home in Studio City, Avanesov has continued using the Mahmee services, working on building her milk supply and consulting nurses about her baby’s health. Once she sent a photo of her baby’s poop to Mahmee’s nurses, asking if it looked normal.
“They have nurses that take a look at these things, so they’re available all the time,” she said. “They respond right away. It’s been a pretty great resource, especially for a first-time mom.”
Teresa M. Claeson, an executive director of women’s health services at Saint John’s, said in recent years the demand for lactation support and other services has been on the rise.
“Having the ability to provide what’s the best for their babies and have that support and knowledge is huge,” she said.
On the second day after her delivery, Vella looked forward to going home with her baby.
“I’m pretty sure I would have a lot of questions, especially about diaper change,” she said as she put Benjamin into the hospital’s baby-warming crib, her blonde hair touching his tiny body. “It’s all very new to me.”
Related links
Pregnant during pandemic: COVID-19 fears fuel increased interest in home births
Pregnant during pandemic: Programs, midwives step up to support Black mothers
Amid coronavirus outbreak, pregnant women reconsidering their delivery plans